Provider Demographics
NPI:1982142006
Name:GENTLE ACUPUNCTURE
Entity Type:Organization
Organization Name:GENTLE ACUPUNCTURE
Other - Org Name:EASTSIDE GENTLE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROKHSAREH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-835-6299
Mailing Address - Street 1:14120 NE183ST
Mailing Address - Street 2:APT 1-410
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:US
Mailing Address - Phone:425-638-9098
Mailing Address - Fax:
Practice Address - Street 1:2227 152ND AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-835-6299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002715171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty